Did you know one in four women over the age of 50 have been shown to have gluteal tendinopathy? Gluteal tendinopathy can greatly impact your daily activities. Whether that is through lack of sleep, inability to walk normal distances or climb stairs without pain or the inability to sit or stand for long periods.

Your gluteal tendons are the tough fibres that connect your gluteal muscle to your hip bone. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time. The buttock or gluteal muscles are extremely important in providing pelvic stability when walking or running. Every time you step on your right foot, your right gluteal muscles are vital in keeping your pelvis stable and preventing your left hip from dropping. The gluteal muscles insert into the outside of the hip via their tendons and these tendons can break down.

What is a Tendon Injury?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of repetitive tendon overloading.

Your tendons are designed to withstand high, repetitive loading, however, on occasions, when the load being applied to the tendon is too great for the tendon to withstand, the tendon begins to become stressed. When tendons become stressed, they sustain small micro tears, which encourage inflammatory chemicals and swelling, which can quickly heal if managed appropriately.

What are the Symptoms of Tendinopathy?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area. The pain may get worse when you use the tendon. You may have more pain and stiffness during the night or when you get up in the morning. The area may be tender, red, warm, or swollen if there is inflammation. You may notice a crunchy sound or feeling when you use the tendon. The symptoms of a tendon injury can be a lot like those caused by bursitis

Can Pilates help?

In order to reduce pain, it is important to avoid positions that load the tendon such as sitting cross-legged, sitting in a low chair or carrying children on hips. Treatment involves strengthening the gluteals and the other pelvic stabilizing muscles. Pilates is a great way of ensuring correct posture and muscle recruitment during various exercises. There are so many exercises for Pilates on the Matts and reformer.

Pilates Exercise:

1: Lying Side Kick/leg circles:

*Lay down on your side in a straight line, shoulder over shoulder, hip over hip, and ankles together.

* Bring both legs forward to 45 degrees form the body line

* Prop the head behind the head, reaching the elbow towards the ceiling.

* Lift top leg to a point level with the pelvis, the pelvis and spine remain stable.

* Lengthen the leg and circle or kick forward in a controlled manner.

* Hinging from the hip, draw the movement back through the heel.

* Repeat.

2: The Clams

* Begin this exercise lying on your side with your shoulders, hips and ankles aligned.

What is the Menopause?

Before I blog about the Menopause, some of you may wonder, how can I give advice about the menopause if I haven’t experienced it. Well, let me explain. For us women, it happens, we can’t avoid it. Some of us have seen our own mothers experience Menopause and at some point, my time will come, but what I can do, is to provide a little bit of advice from the knowledge I have gained over the years.

Menopause, also known as the “change of life” is the time in most women’s lives when menstrual periods stop permanently, and they are no longer able to have children. This will normally occurs between 45 and 55 years of age with Medical professionals often define menopause as having occurred when a woman has not had any vaginal bleeding for a year. It’s a stage of life, when women become deeply concerned about aging and feel like the best of life is now behind, as their body starts demonstrating unpleasant changes and their emotions seem to run out of control.

Symptoms of the Menopause.

Before menopause, the functioning of the ovaries and the secretion of the female hormones estrogen and progesterone decline. The reduction in the levels of estrogen create a hormonal imbalance that results in several physical an psychological symptoms.

Woman’s periods typically become irregular, which means that periods may be longer or shorter in duration, or be lighter or heavier in terms of the amount of flow. These changes generally happen several years before the actual menopause begins. This transition phase is called perimenopause. During this time, women will often experience hot flushes which will typically last from 30 seconds to ten minutes and may often stop occurring after a year or two. Other symptoms may include vaginal dryness, mood changes and trouble sleeping.

Menopause and your bone health

Women can lose up to 20% of their bone density in the five to seven years after the menopause. This makes post-menopausal women more at risk of Osteoporosis which may increase weak bones and fractures. Pilates, specifically, is a form of exercise that is often mentioned with regard to osteoporosis. But in Pilates there are definite parameters as far as what exercises are appropriate for osteoporosis.

We must have strong bones that can bear our weight and allow us mobility

Bone is a dynamic tissue, like muscle, that strengthens in response to forces it has to resist. Gravity is one such force, and working against gravity is what we refer to when speaking of “weight-bearing exercise.” The combination of compression and tension from gravity and from our muscles plays a major role in bone strengthening.

The resistance can come from weights, elastic bands, but you can also consider your own body weight as resistance in some instances, like a push-up. In this example, you’re using gravity and your own body weight to provide resistance and induce muscle pull.

Pilates Benefits and Exercises.

Pilates exercises can improve brain activity, improve the general attitude towards life, increase alertness during the day and enable a restful sleep at the end of the day.

Pilates is very much focused on Breathing, Strength, Balance, Flexibility, Endurance and Coordination.

Breathing and Relaxation: Breathing reduces stress, can help with anxiety attacks and helps to attain clam and enhance focus.

Strength: A decline in estrogen levels, will be a decline in bone density, however, exercises bearing resistance may help reduce and even reverse this effect.

Balance: Balance exercises will focus on enhancing your posture and body awareness which can help prevent falls and avoid injuries.

Flexibility: These exercises are so important to keep muscles flexible and to reduce pain and stiffness in the body.

Back Extensions:(The Dart – upper back extensions, Forward Stretch, Opposite Arm and Leg Reaches, The Saw) Working on back extension is imperative for clients in the Menopause. As we age, we have the tendency to lose good posture, weakening more and more the strength in our back extension muscles. We need to focus on strengthening our scapulars, mid to lower trapezius, rhomboids and serratus anterior.

Arm work: (Triceps Press/Bicep Curl with Resistance Band) is essential for clients in menopause, as they lose fat deposits in the arms and the skin gets saggy especially in the triceps area. It is crucial to strengthen and build up muscle taking in consideration that as we age we have more difficulties to do any kind of over-head arm work exercises. . The aim is to develop arm and shoulder strength, flexibility and control. It is imperative for the client to pay special attention to core strength and stability, good posture and alignment. Considering that at this stage there is a tendency of kyphosis (I refer to my clients as stressed shoulders….relax!!!) the correct placement of the shoulders before performing the arm work block.

Lateral flexion rotation: (Mermaid, Side Bend) Focusing on abdominal control with emphasis on the oblique’s, spinal mobility and scapular stabilization. The sides of the trunk generally become weaker as the muscles lose some tone with the aging process.

The Core:(Hundred, Double Leg Stretch, Toe Taps, and The Bicycle) this is an area of the body where women in menopause lose tone and gain weight.

Hip Work: (Bicycle, Hip Rolls, One leg Circle) this area tends to lose strength and stability. It is important to keep this area functional to help prevent issues with balance.

Stretching: It is of great importance for women in this stage to stretch in order to keep muscles flexible and reduce future pain and stiffness in the body

Its not all Doom and Gloom

In addition to the biological an physiological changes, women at this stage in life (unless you have started the menopause at an earlier age) are generally experiencing changes in their family structure, as their grown children have started to leave their home and it’s at this time, when women can finally have more time to dedicate for themselves. To pursue their interest and passions, and to connect with their friends, to experience a sense of freedom.

Not everyone enjoys the winter months. Long dark evenings make it difficult to get out in the fresh air, wind and weather encourages you to stay indoors, low temperatures turn you to comfort foods and the combination of central heating and frosty outdoors can make your skin dry and tight.

But it doesn’t have to be like that! Here are some ways to energise the winter months so you look and feel great.

Winter-proof your skin

Stay hydrated by drinking lots of water and moisturising really well. Eat lots of antioxidants to keep your skin bright and exfoliate once a week to get rid of the dead cells.

Brighten your mood

The winter can dampen the liveliest of spirits – researchers believe it’s the lack of light that interferes with the hormones in the brain and reduces serotonin – the feel good hormone. But even on the worst day there is 30 times more light outdoors than in, so even if its bad do try to get outside every day even if its only for a short time. Make the most of natural daylight by pulling back curtains, and sitting by windows. If you suffer really badly from lack of light, consider a light box.

You can also boost your mood by eating foods rich in tryptophan which your body uses to make the happy hormone serotonin. Eat fish, turkey, chicken, cheese, beans, tofu, oats and eggs. Taking a supplement of something like St Johns Wort may also help brighten your mood.

Asthma, respiratory problems and heart attacks are more common in the winter because colds and flu can be a trigger. The best way to keep your heart and lungs healthy is to exercise aerobically as much as possible – at least 30 minutes, 3 times a week. You can also eat oily fish and other foods that provide Omega 3 fatty acids which help against heart disease.

Juicing has many benefits which exceed those of eating solid fruits and vegetables and is an effective way to do something good for you body which involves drinking fruit and vegetable juices.

Your body can quickly absorb larger amounts of nutrients from juices than from solid foods because the process of digestion that is necessary when you eat whole foods is bypassed. Raw fruits and vegetables contain many substances that enhance health, and juicing benefits the body by providing the most concentrated and readily absorbed source of these substances.

We are recommended that we get 5 servings of vegetables and fruits per day and very few of us actually get that. Juicing is an easy way to virtually guarantee that you will reach your daily target for vegetables.

Juicing helps you absorb all the nutrients from the vegetables. This is important because most of us have impaired digestion as a result of making less-than-optimal food choices over many years. This limits your body’s ability to absorb all the nutrients from the vegetables. Juicing will help to “pre-digest” them for you, so you will receive most of the nutrition, rather than having it go down the toilet.

Other benefits is that it is an easy way to get beneficial enzymes, which are primarily found in raw foods, into the body. Enzymes in fresh fruits and vegetables have the vital role of converting food into body tissue and energy. Enzymes are also involved in metabolism, so one of the more valuable health benefits of juicing is that it can increase metabolic rate. Juicing also ensures that the body is getting sufficient amounts of phytochemicals, substances in plants that are considered among the most powerful ways to fight disease. While most people do not eat enough raw fruits and vegetables to obtain the amount of phytochemicals that would make a difference, it is relatively easy to drink enough juice to obtain sufficient amounts of these powerful nutrients. In addition, antioxidants and other immune enhancing properties are concentrated in juices.

Juicing can also been known to accelerate recovery from illness. In specific combinations of fruits or vegetables, you can target particular conditions and improve or alleviate symptoms.

It is important to note that vegetable juice has very little protein and virtually no fat so by itself it is not really a complete food. It really should be used in addition to your regular meals not in place of it, so I use it as my morning or afternoon snack

Over the years, this has to be the most popular question I am asked and normally clients will say, can you recommend me some good tummy exercises. Getting a flat tummy isn’t all about doing abdominal exercises; there are many other factors that you need to do to achieve this goal.

My goal for 2013 is quiet simple….aiming for a six pack, or 8 pack to be exact. If I’m being totally honest, it’s not simple, well it is, but it’s going to be very hard. Two ways to get a flatter tummy is to train hard (that’s the easy part for me) and look at what your eating (this is my weakness), even Personal Trainers have a weaknesses and food is one of them for me.

So let me begin and let’s share this journey together!!

1: Cardio – high intensity interval workouts

Cardio workouts are an important step to get six pack abs: This is a MUST!!!! You need to lose some of that extra fat over your abs. Even if you work your core and abs hard, if there is still a layer of fat over them no one will ever get to see them.

Cardio workouts are workouts that raise your heart rate for a given set of time. I personally would recommend Kettlebells which are great for burning off fat as you are getting a great cardio workout whilst using resistance…….perfect for burning that fat away, but you can also take up jogging, dancing, rowing etc….aim for at least 3 x a week, 30 minutes. Remember, if you concentrate on just running, you may lose some body a fat, but it isn’t enough to produce a 6 pack…more work is still required.

2: Lift weights – the whole body area

The more muscle your body has, the more calories your body burns, even at rest. I can’t stress enough the importance of doing some resistance work for the whole body, plus, resistance training is important to limit the amount of muscle mass lost whilst reducing your calorie intake. If you only do cardiovascular exercises (running, playing basketball, football) without weight training then you may lose the muscle mass, including the muscle in your abs. Think of Jessica Ennis, she doesn’t get a six pack from training on the athletics track, she also, lifts weights. You have to think of the whole package, but just the tummy area.

3: Build Muscle

So like above, you need to build muscles up around your tummy, however, do plenty of abs work in an upright position which is more functional: it’s no good teaching your body to activate your core only when lying down.

Medicine Ball Woodchops Keeping your hips fixed forward, hold a 3-5kg medicine ball with your arms fully extended to one side at head height, then power it diagonally down in a wood chop action. Do this for 30 seconds on one side, 10 seconds rest, and then 30 seconds the other side.

Rollouts One of the best ways to train your rectus abdominis is with rollouts, which can be performed using a Swiss ball or Power Wheel. Rollouts have been shown to work better than crunches, sit ups and even hanging knee ups for activating both upper and lower abs.

Crunches. We all love our crunches. It is very important to not lift your entire back off the floor when performing crunches as this can cause back strain, and the extended movement does not help you develop six pack abs any faster. The most important part of the crunch is the initial flexing of your abs as you lift your shoulders off the floor. As soon as you begin lifting off the floor exhale through your mouth, ending with a gasp once your shoulders are off the floor. Then pause for a second once you are at the top of the crunch and exhale the last bit of air from your diaphragm while flexing your abs. Now lower back down slowly and controlled while inhaling through your nose, just until your shoulder blades touch the ground. Do not let your head touch the ground.

Sit ups. Lie on the floor, feet on the floor, knees up and hands crossed on your chest. Have someone hold your feet down, or wedge them underneath something heavy. Sit all the way up, lifting your lower back off the floor along with your shoulder blades. Keep your back straight (no hunching). Lower yourself down. Repeat. Once this becomes relatively easy for you (i.e. you can do a quite a bit with ease) start adding more challenges. Find an incline bench. Do weighted sit ups. Hold a weight on your chest while you do these. As these become easier, hold heavier and heavier weights.

There are many more exercises which I will put a video together to show you some examples.

4: Core strength

You need to train your entire core. To build really great abs it’s important to first understand what abs do. Their full name is ‘rectus abdominis’. Contrary to popular opinion, the abs’ primary job is not to curl you up into a ball, but they work together with the back muscles to maintain correct posture and stabilise your spine. So the best exercises for abs are ones that force your entire core to go into overdrive to support your spine. Some exercises that do this are squats and deadlifts. These exercises will train your entire core to work together to do what it is designed to do. At the same time they will also train a lot of other muscles such as glutes and quads.

Finding a good Pilates class will also work the core muscles as well as activating other supported muscles, building your back muscles and improve your posture.

You can also add complex core-movements to your workout. This will boost your overall body constitution tremendously. You could try and combine push-ups with rows. Go into a push-up position on two dumbbells. Now don’t do a push-up, but instead start to row alternating dumbbells. See how much power you need only to hold balance? Combine exercises! Be creative. Tension is your friend.

5: Train your oblique muscles.

It’s not as important to work on your oblique muscles at first, but eventually you’ll want to start working these too. These are the muscles to either side of your stomach. There are multiple ways to do this and anything that includes twisting your torso against a resistance counts. There are twisting machines at gyms, you can twist while you do sit-ups, you can do side bends, you can twist side to side with a medicine ball in hand, etc.

Bicycle crunches. Lift your feet off the ground while doing the crunches by alternating each leg in the air. Bring your left knee up toward your right shoulder and then your right knee toward your left shoulder.

Pull-ups hanging from a horizontal bar. You will be amazed at the number of muscles around your stomach working with pull-ups. Do 5 pull-ups with your palms facing away from you and 5 pull-ups with your palms facing towards you. This will also build your pectorals and biceps at the same time.

Stability ball. Do your crunches on the ball to introduce instability to your workout, which will improve your balance too. Do this as often as you are comfortable or at times when it won’t look weird.

6: Eat breakfast.

Many people skip breakfast because they don’t have time for it or they think fewer calories will help to lose a few pounds. I am surprised the amount of clients that. See never eat breakfast. The harm of skipping breakfast from a weight loss perspective is it makes you eat a huge lunch since your body hasn’t had anything in the past 12 (or more) hours. When you eat a huge lunch you get that after meal drowsiness so now you’re both unproductive and inactive. Cereals don’t take much time to prepare and consume, and most of them are very healthy nowadays, but do take a look at the sugar content. If you are extremely pressed for time, consider grabbing a box of breakfast bars or a smoothie and throwing one in your bag when you leave for work. Some breakfast bars out there are also excellent sources of fiber. Even an apple or a yogurt is better than nothing.

Ideally, your breakfast should be the biggest meal of the day, lunch the second, and dinner the smallest.

7: Keep metabolism steady.

Eating one small meal every three hours that you are awake will not speed up your metabolism, rather, it will keep it going. Your metabolism goes and slows with your food intake and eating something small every three hours will keep that metabolism burning calories and will help you lose weight. Every meal should include lean protein, so that your body won’t need to break down your muscles for fuel, which would shrink your abs as well as slow down your metabolism. Fresh fruits or vegetables are excellent choices for curbing appetite not to mention other health benefits. A handful of nuts might do the same. Drink a large glass of water before sitting at the table will also help.

8: Drink more water every day.

An average person should be drinking 2 litres of water a day. It sounds like an absurd amount of water, but you get water from the food you eat, and you can drink teas and pure fruit juices to make up some of the quota.

Drinking too much water (several liters, especially while sweating) can dangerously dilute certain salts and minerals. If you are exercising heavily and sweating a lot, you will need to replace your salts as well as fluids. Supplement your water drinking with a sports drink or potassium rich fruits such as bananas and apples.

9: Swap refined grains for whole grains.

A diet rich in whole grains changes the glucose and insulin response in your body, which hastens the melting of fat, and visceral fat, that deep layer of fat, is easier for your body to burn than the subcutaneous fat under your skin (the fat that you can see and grab). In a scientific study, people who ate all whole grains (in addition to five servings of fruits and vegetables, three servings of low-fat dairy, and two servings of lean meat, fish, or poultry) lost more belly fat than another group that ate the same diet, but with all refined grains. Not only will whole grains help reduce fat, it also helps digestion issues.

10: Essential Fatty acids – Omega 3 & 6

So we need to lower our fat intake but we also need to ensure we have the correct balance of essential fats…….these are also known as the good fats. These oils Significantly increased lean mass and decreased fat mass

Fat has to be the most debated part of food, however, fat is an essential part of our diet if we are to function properly.
Omega 3 and 6 are the two essential fatty acids which help the cardiovascular, reproductive, immune and nervous system to function as well as being involved in manufacture and repair of all membrane cells.

Omega 3 fat sources have anti inflammatory properties so it is good for joints and injuries.

Fish oil (the best source of Omega 3 fats) increases basal metabolic rate helping you burn more calories overall. Fish oil also improves the use of fat as a fuel source during exercise meaning you use less muscle glycogen and more fat for your training. This means you lose body fat faster.

Omega 6 fats are found in walnuts, sunflower seeds, sunflower oil and whetgerm.
These are a healthier fats. They are believed to reduce cholesterol and help reduce heart disease and offering some protection against cancers.

Kettlebell training has developed over the last number of years into one of the most popular forms of training within the fitness industry.

So what makes a kettlebell so unique? Whats the difference between the kettlebell and a barbell, medicine ball or any other training tools. A good trainer will never limit themeselves to using a single tool, however, the kettlebell is a very versatile tool, and so it can be used for a variety of different exercises, working different muscles across a range of human movements patterns, we should then try to utilise it as much as possilbe, where appropriate.

The Kettlebell can be used to improve grip strength and endurance, teach a correct lifting technque and develop strength and endurance in the hamstrings, gluteals and back muscles. It will help to improve coordination and is used as a preferred tool for fat loss and can even give its users improvements in aerobic and anerobic fitness.

Humans have undertaken particular movement patterns for thousands of years, and we should incorporate these same patterns into our strutured exercise programme to best improve performance.

Kettlebells can be used to train a variety of primal human movements patterns, in particular the lift, press and pull patterns.

Metabolic Acceleration

Kettlebells are always strongly advocated as being particulary effective for increasing metablism and initiating positive changes in body composition. Therefore, training at a sufficient intensity with kettlebells may inititate beneficial changes in metabolic rate, resulting in maintenace of lean muscle and decrease in body fat. A significant increase in lean body mass can be achieved with kettlebell training, so dumbbells, barbells and fixed path machines would be tools more suited to bodybuilding than kettlebells.

Many of the foundation drills, such as the two hand swing, one hand swing, snatch and clean, should improve coordination between the lower body and the upper body when performed correctly. The individual should then contract the loaded muscles, bringing the hips forward, with creates momentum and force. The force should then be transfered through the core muscles to the shoulders and arms, and eventually to the handle of the kettlebell, which casuse the bell to rise in an arc motion.

Exercises

Two hand with one Kettlebell
Dead swing with finger release with one Kettlebell
Two hand swings with one Kettlebell
One hand swing with one Kettlebell
One hand high pulls with one kettlebell
One hand snatch with one kettlebell
One hand swing clean
One hand dead clean with one kettlebell
One hand front squat
One hand overhead press
One hand turkish get up
One hand windmill

Plus many more!

An effective warm-up is essential to any training programme, but especially when training with Kettlebells. Kettlebell lifting is demanding on the entire body and it is critical that it has been well prepared for the dynamic nature of many of these exercises.

To find out more about my Kettlebell classes which are starting in October at Frank Hutchings Hall, Thatcham at 8pm, please contact me on

Pilates exercises are common place at physical therapy centers, chiropractors are recommending Pilates, and “My back used to hurt all the time and now I don’t feel it anymore” is a phrase I hear a lot from people who do Pilates consistently. So what is it about Pilates that works so well for back pain relief?

What makes Pilates so effective is that it addresses the underlying structural imbalances in the body that lead to back pain. Issues like lack of core support, pelvic instability, muscular imbalances, poor posture, and lack of body awareness all effect back health.

Pilates Helps Correct Posture

In Pilates, we pay a lot of attention to how our body parts are lined up in relation to each other, which is our alignment. We usually think of our alignment as our posture, but good posture is a dynamic process, dependent on the body’s ability to align its parts to respond to varying demands effectively. When alignment is off, uneven stresses on the skeleton, especially the spine, are the result. Pilates exercises, done with attention to alignment, create uniform muscle use and development, allowing movement to flow through the body in a natural way.

For example, one of the most common postural imbalances that people have is the tendency to either tuck or tilt the pelvis. Both positions create weaknesses on one side of the body and overly tight areas on the other. They deny the spine the support of its natural curves and create a domino effect of aches and pains all the way up the spine and into the neck. Doing Pilates increases the awareness of the proper placement of the spine and pelvis, and creates the inner strength to support the natural curves of the spine. This is called having a neutral spine and it has been the key to better backs for many people.

Pilates Develops Core Strength

Good posture that goes beyond the “look” of being aligned requires core strength. Having core strength means that all of the muscles of the trunk of your body are strong, flexible, and working together to support and stabilise the spine.

Core strength is deeper than the big surface muscles that we are used to thinking of as those of the trunk of the body, like the rectus abdominis, the infamous 6-pack abs muscle or the beautiful big muscles of the back, like the lattisimus dorsi, popularly called “the lats.” The core muscles include the muscles that are below the surface musculature.

So while many forms of exercise focus on strengthening the big surface muscles, Pilates trains the body so that all of the core muscles work together to support and stabilise the back. Part of developing effective core strength is to train the body to know when to release, as well as activate, its core muscles. So while core strength is the catch-all term, we might say that the core coherence that Pilates teaches is essential for back health.

Some of these less obvious but very important core muscles are the muscles of the pelvic floor; the psoas, which play a huge role in keeping us upright and in hip bending; the transversospinalis, which are small muscles that weave along the spine; and the transverse and oblique abdominal muscles. The diaphragm, our prime breathing muscle, is right in the middle of the core. All of these muscles play crucial roles in the support and stability of the spine.

A healthy spine can curve forward and backward, twist, and move side to side, and do so in a way that reveals all the subtle articulations that our many vertebrae allow us to have. As core strength develops, the back muscles learn to work in harmony with the abdominal muscles, forming protective support for the spine that increase the potential range of motion of the spine. Pilates exercises are easy to modify so that we can develop spinal flexibility at our own pace. This is one of the things about Pilates that makes it easy for people with back pain to work with.

Pilates Increases Body Awareness

Whether the cause of pain is from an injury or as is often the case, a culmination of the effects of poor posture and inefficient movement habits, back pain is a messenger letting us know that we have to pay more attention to how we live in our bodies. The Pilates method is full attention exercise. You can’t do Pilates without becoming extremely aware of your alignment and the energy you bring to movement.

This kind of awareness practice is extremely powerful for people with back pain because we not only improve physical functioning, but as awareness increases, we move beyond the physical and mental holding patterns that back pain can create

Back pain has many causes and Pilates may not be right for all of them. If you have back pain, especially serious or chronic back pain, please check with your health care practitioner before you begin a Pilates program. If you do choose to begin Pilates, it is important to work with a fully certified instructor who is aware of exactly what challenges you are working with.